Vaginal application of lactobacilli in the prophylaxis of recurrent lower urinary tract infection in women

OBJECTIVE: To examine whether vaginal application of Lactobacillus casei v. rhamnosus reduces the reinfection rate in cystitis-prone women. DESIGN: A controlled, randomized, double-blind clinical trial. SETTING: Division for General Practice, University of Bergen, Norway. INTERVENTION: Vaginal application of lactobacilli twice weekly. SUBJECTS: 47 women, aged 18-50 years, reporting three or more episodes of distal urinary symptoms during the previous 12 months, of which at least one episode had been medically verified as a lower UTI. MAIN OUTCOME MEASURE: The incidence rate of lower UTI during 6 months' follow-up. RESULTS: No difference in infection rate between the two groups; the incidence rate ratio between the treatment group and the placebo group was 1.41 (95% confidence interval 0.88-1.98). Lactobacilli were not found more frequently periurethrally in the treatment group than in the control group. CONCLUSION: It is still uncertain whether vaginal application of lactobacilli reduces the infection rate in cystitis-prone women.